Medical instrument having a manipulator

ABSTRACT

The description relates to a medical and especially an endoscopic instrument having a manipulator with a guide channel on which are arranged at least one drive and at least one guide wheel or roller the peripheral surface of which can be engaged with the outer contour of an instrument part in such a way that this instrument part can be moved to and from along its longitudinal axis in relation to the manipulator. The instrument of the invention is distinguished in that, to fit different outside diameters of the instrument part to be moved, at least one of the wheels can be moved at least in the direction perpendicular to the guide channel and/or at least one of the wheels has an elastic coating on its outer periphery.

TECHNICAL FIELD

The present invention relates to a medical instrument and, inparticular, to an endoscopic instrument having a manipulator accordingto the generic part of claim 1.

STATE OF THE ART

In a number of cases, it is necessary to move two, in particular,medical instruments precisely toward each other respectively oneinstrument part relative to the basic instrument. An example of this ismoving tongs in a work channel of an endoscope shaft. Further examplesare moving a laser fiber or a guide wire in a catheter or a flexiblethin or ultra thin endoscope relative to the handpiece.

Known manipulators have a guide channel on which at least one drivingwheel respectively driving roller and at least one guide wheel,preferably guide wheel whose perimeter area can be brought to engagewith the outer contour of an instrument part in such a manner that thisinstrument part can be moved forward and backward in direction of itslongitudinal axis to the manipulator. By way of illustration,manipulators for the relative movement of two instruments in directionof their longitudinal axis can be designed in such a manner that an(inner instrument) is inserted partially in a work channel of the otherinstrument (outer instrument).

In practice, it is frequently necessary to operate, i.e., move,instruments with different diameters successively in an endoscope orcatheter. Furthermore, flexible endoscopes may have, i.a., due tofabrication tolerances, at least small variations in the outsidediameter, which is quite detrimental to non-slip, preferablyfriction-free handling using known manipulators.

A manipulator which would permit handling instruments, preferablyinstruments parts having greatly different diameters has hitherto beenunknown in the medical technology field.

Manipulators, like the aforedescribed ones, are moreover only suited foruse in medicine in certain circumstances, because they are not easy tosterilize due to their complicated construction.

DESCRIPTION OF THE INVENTION

The object of the present invention is to provide a manipulator formoving an instrument part in relation to a basic manipulator body,preferably for the relative movement of two instruments which permitshandling, preferably moving instruments having different diameters and,moreover, which is easy to sterilize.

A solution to this object according to the present invention is setforth in claim 1 hereto. Further improvements of the present invention,which can partly be viewed as independent inventions, are the subjectmatter of claim 2.

According to the present invention, an instrument having a manipulatoris created which is distinguished by, for adaption to the differentoutside diameters, at least one of the wheels being moveable at least inthe direction perpendicular to the guide channel and/or the outercontour of at least one of the wheels being provided with an elasticcoating.

The moveability of at least one of the wheels respectively the rollersperpendicular to the moving direction also permits moving instruments,preferably instrument parts having greatly different diameters forwardand backward successively with one and the same manipulator in the workchannel of an instrument, by way of illustration an endoscope shaft.

If, on the other hand, it is only necessary to compensate fabricationvariations in the outside diameters of, for instance, ultra thinflexible endoscopes for reliable and non-slip moving it suffices todesign the perimeter of at least one of the wheels, preferably rollerselastically.

Invented further improvements respectively embodiments are set forth inclaim 2 and the following claims.

The invented manipulator can, of course, be provided with multiplewheels, preferably rollers, for instance three rollers, for moving andguiding the instrument part to be moved, because particularly threerollers ensure reliable "straight guidance". The particularly simpleembodiment described in claim 2 is a manipulator having two wheelspositioned opposite each other.

In order to avoid slippage and/or in order to compensate differences indiameter due to fabrication, according to claim 3, it is preferable ifat least the drive wheel or wheels are coated with a rubber-like elasticmaterial in the region with which they engage with the outer contour ofthe to-be-moved instrument part permitting in this manner particularlyprecise work. The rubber-like material can, in particular, be siliconerubber (claim 4).

Claim 5 describes an especially preferred embodiment of the presentinvention in which the "large surface" contacting of the wheels of theto-be-handled instrument part ensures particularly reliable and preciseadvancing of the instrument to be moved.

In this embodiment, the perimeters of the wheels are provided withtwo-O-rings. Furthermore, the wheels are disposed in such a manner thattwo O-rings lie opposite each other respectively and that the O-ringsenclose a gap through which the instrument part passes. The use ofO-rings has the advantage that they can be easily exchanged and/orcleaned, preferably sterilized, which is especially advantageous in thefield of medicine.

Another preferred embodiment of the present invention is set forth inclaim 6:

In this embodiment, the moveable wheel for adaption to differentdiameters of the parts of the instrument is joined to a swivelingcarrier in such a manner that the distance between the swivel axisthereof and the axis of rotation of this wheel does not equal zero. Inother words, for the adaption of different instrument diameters, themoveable wheel is borne eccentrically on the swivel carrier.

The carrier can, in particular, be a disk which can be turned about itscenter axis and on which the axis of rotation of the wheel is placedeccentrically, with the wheel being moved by turning the disk (claim 7).Furthermore, it is preferred if the carrier has a circular outer contourin the cross sections that are perpendicular to the swivel axis and canbe turned, in particular by hand, at least 360°. In this way, thecarrier can be turned "to the left or the right" until the wheel joinedto it eccentrically contacts the respective instrument to-be movedforward and backward in a sufficiently firm manner that the instrumentcan be moved without slippage.

An alternative embodiment is described in claim 9, in which, foradaption to the different diameters of the parts of instrument by movingone of the wheels, two screws are provided which act on the axis of thiswheel, preferably the roller. In this embodiment, it is preferred if theaxis of the moveable wheel is pretensioned by a spring in the oppositedirection of the screw direction (claim 10).

Irregardless of the steering of the moveable wheel, according to claim11, it is advantageous if the moveable wheel for adaption to thedifferent instrument diameters is the drive wheel. Notably in this way,by turning, preferably swiveling the carrier, the contact pressure canbe directly set in such a manner that a momentum sufficient for movingthe instrument part can be transmitted and therewith difficult handlingtasks can also be solved.

In addition, it is preferred if, according to the further improvementdescribed in claim 12, the drive wheel has a substantially smallerdiameter than the guide wheel or wheels.

Thereby it, notably the instrument, preferably the instrument part, canbe moved precisely forward and backward, because a large angle ofrotation of the drive wheel is required for small movements, withreliable guidance being ensured by the large guide wheel.

The invented instrument can be designed in a grat variety of ways:

By way of illustration, the wheels can be disposed in a handpiece whichis provided with a channel for the to-be-moved instrument part. Thisembodiment is especially suited for handling, preferably moving thinflexible endoscopes (claim 13).

In a further improvement, the manipulator is provided at least on oneside of the guide channel with a standard flange for connection to oneof the instruments.

This standard flange can, by way of illustration, be a Luer-lock flangeor an endoscope shaft flange. By means of this further improvement, theinvented manipulator can be attached to existent catheters or endoscopeshafts without needing to change, preferably adapt the latter in anymanner.

The invented manipulator can, of course, be firmly connected to one ofthe instruments, i.e., to the basic body, preferably the manipulator canbe integrated in an instrument, as by way of illustration in anendoscope shaft.

Irregardless of the aforedescribed details of the embodiment of theinvented instrument it is advantageous especially for medicalapplications if the wheel carrier is attached in a detachable manner ina manipulator basic body (claim 18) and/ or the shaft of the drive wheelis attached in the carrier in a detachable manner (claim 19). By thismeans, easy cleaning and sterilization of the manipulator is ensured,because the difficult to sterilize parts of the channel become easilyaccessible by this means.

The drive wheel provided in the instrument designed according to thepresent invention can be motor-driven, by way of illustration controlledby an electronic control wheel, or driven by an operation person byhand, directly or via an intermediate gear.

With the invented instrument various instrument parts, such as tongs,scissors, laser fibers, guide wires for catheters or flexible endoscopescan be moved forward and backward. In the event the flexible endoscopesare to be handled with a flexible image conductor and a flexibleillumination light conductor, it is preferred if the manipulator isprovided at its distal end with a guide channel for the flexible fiberunit, which has, compared to the channel at the proximal end of thehandpiece, a substantially smaller diameter.

BRIEF DESCRIPTION OF THE DRAWING

In the following, the present invention is made more apparent by way ofexample using preferred embodiments without the intention of limitingthe scope or spirit of the overall inventive concept with reference tothe drawing, depicting in:

FIG. 1 an isometric view of a first preferred embodiment of theinvention, and

FIGS. 1a to 1d four different cross sections preferably views of a firstpreferred embodiment of the present invention, and

FIGS. 2a to 2d two variants of a second preferred embodiment.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

FIGS. 1a to 1d show sections A--A, B--B, C--C and D--D through themanipulator of a first preferred embodiment of the present invention.

The manipulator is provided with a basic body 1 in which a guide channel2 is provided in which, in FIG. 1b on the left side, an instrumentpreferably an instrument part can be inserted and can be moved forwardto the right. The instrument which, by way of illustration, can be aflexible endoscope is not shown in FIGS. 1a to 1d.

In order to move the instrument forward and backward, a drive wheel 3and a guide wheel 4 are disposed in the guide channel 2, the perimeterof which engages with the outer contour of the not depicted instrumentpart.

By turning the drive wheel 3, the instrument, preferably the instrumentpart is moved forward and backward in direction of its longitudinal axisrelative to the manipulator 1.

For adaption to the outside diameter of the to-be-moved instrumentparts, the drive wheel 3 is joined to a rotatable carrier, preferably adisk 5 in such a manner that the distance between the rotation axis 5'of the disk and the rotation of axis 3' of the drive wheel 3 is unequalzero. In other words, the drive wheel 3 is attached eccentrically to thedisk 5. In this way, the carrier 5 can be turned "to the left or theright" until the drive wheel 3 eccentrically attached to it contactssufficiently firmly the respective forward and backward movinginstrument, preferably instrument part located in channel 2 in such amanner that the instrument can be moved precisely without slippage.

In order to turn the drive wheel 3, the wheel is, in certaincircumstances via a gear or a transmission, connected to an operationpart 6 by means of which an operating person can turn the drive wheel 3by hand.

In order to simplify cleaning, preferably sterilizing the manipulator 1set up according to the present invention, the carrier 5 for the movabledrive wheel 3 is attached in the manipulator basic body 1 in adetachable manner. In this case, a pin 7 is provided in the longitudinalaxis of the latter having a profile that permits removing the carrier,preferably the disk 5 from the basic body 1 of the manipulator aftermoving the pin 7. An O-ring 8 is provided to seal the carrier 5 from thebasic body 1. The shaft 6 of the drive wheel 3 is also inserted in adetachable manner by means of the O-ring 9.

Furthermore, the manipulator is provided on both sides of the guidechannel with a standard flange, by way of illustration a Luer-lockflange 11 and a conventional endoscope flange 12, like by way ofillustration the standard flange from Karl Storz GmbH & Co., Germany.

Moreover, in the region with which they engage with the outer contour ofthe to-be-moved instrument part, the drive wheel 3 and the guide wheel 4are coated with a rubber-like material 3" and 4", such as by way ofillustration a silicone rubber in such a manner that slippage is furtherminimized.

FIGS. 2a to 2d show two variants of a second preferred embodiment inwhich the parts corresponding to those in FIG. 1 bear the same referencenumbers, thereby obviating renewed presentation.

In the second preferred embodiment, the basic body 1 is designed as ahandpiece in which the channel 2 is provided for the to-be movedinstrument part. The instrument part can, in particular, be a flexiblethin endoscope which is transported in an extension 13 of the handpiece1.

In the second preferred embodiment, the perimeters of the drive wheel 3and the guide wheel 4 are provided with two O-rings 14 preferably. Thewheels 3 and 4 are disposed in such a manner that in each case twoO-rings are positioned opposite each other and that the O-rings enclosea gap through which the instrument, preferably the instrument partpasses.

The variant shown in a longitudinal section in FIG. 2a and in a crosssection in FIG. 2c in A--A differs from the variant shown in thecorresponding FIGS. 2b and 2c in that in the former instance, foradapting to different instrument part diameters, two screws 15 areprovided for moving the guide wheel 4, which act upon the axis 16 of thewheel 4. The axis 16 of the guide wheel 4 can be pretensioned in theopposite direction of the screwing direction of screws 15 by a notdepicted spring.

In the preferred embodiment shown in FIG. 2, the drive wheel 3 is drivendirectly, by way of illustration using the thumb. For this reason, thedrive wheel 3 has a greater diameter than the guide wheel 4.

With regard to the details not explained in more detail in the text,reference is made to the drawing without the intention of limiting forthe exemplary description the scope or spirit of the overall inventiveconcept, as set forth in the claims.

What is claimed is:
 1. A medical instrument and, in particular, anendoscopic instrument which is provided with a manipulator having aguide channel on which at least one drive wheel and at least one guidewheel preferably are disposed, the perimeter area of which can bebrought to engage with the outer contour of an instrument part in such amanner that said instrument can be moved forward and backward in thedirection of its longitudinal axis relative to said manipulator,characterized by for adaption to the different outside diameters of theto-be-moved instrument parts, at least one of said wheels being joinedto a carrier which can be swiveled to be moveable at least in thedirection perpendicular to said guide channel, the distance between aswivel axis of said carrier and the axis of rotation of said wheel isunequal zero.
 2. An instrument according to claim 1, characterized bysaid wheels being disposed in a handpiece, which is provided with achannel for said to-be-moved instrument part.
 3. An instrument accordingto claim 1, characterized by said manipulator being provided at least onone side of said guide channel with a standard flange for connection tosaid instrument.
 4. An instrument according to claim 3, characterized bysaid standard flange being a Luer-lock flange.
 5. An instrumentaccording to claim 3, characterized by said standard flange being aconventional endoscope shaft flange and, in particular, a bayonetflange.
 6. An instrument according to claim 1, characterized by saidmanipulator being firmly connected to a basic body of said instrument.7. An instrument according to claim 1, characterized by said carrier forsaid moveable wheel being attached in a manipulator basic body in adetachable manner.
 8. An instrument according to claim 1, characterizedby the shaft of said drive wheel being attached in said wheel carrier ina detachable manner.
 9. An instrument according to claim 1,characterized by said drive wheel being driven by hand by an operatingperson.
 10. An instrument according to claim 1, characterized by saidinstrument part being an endoscope having a flexible image conductor anda flexible illumination light conductor, which are combined into aflexible fiber unit having a small diameter.
 11. An endoscope accordingto claim 10, characterized by said manipulator being provided at itsdistal end with a guide channel for said flexible fiber unit, which has,compared to the channel at the proximal end of the handpiece, asubstantially smaller diameter.
 12. An instrument according to claim 1,characterized by said manipulator having two wheels positioned oppositeeach other.
 13. An instrument according to claim 1, characterized bysaid drive wheel being coated with a rubber-like material in the regionwith which it engages with the outer contour of said to-be-movedinstrument part.
 14. An instrument according to claim 1, characterizedby said carrier being a disk which can be rotated about its center axisand the axis of rotation of said moveable wheel being attachedeccentrically thereon.
 15. An instrument according to claim 1,characterized by said carrier having a circular outer contour in thesections perpendicular to the swivel axis and being rotatable by atleast 360°, in particular, by hand.
 16. An instrument according to claim1, characterized by said drive wheel having a substantially smallerdiameter than said guide wheel.
 17. An instrument according to claim 1,characterized by said drive wheel having a substantially smallerdiameter than said at least one guide wheel.
 18. An instrument accordingto claim 1, characterized by said wheel being disposed in a handpiece,which is provided with a channel for said to-be-moved instrument part.19. An instrument according to claim 1, characterized by said carrierfor said moveable wheel being attached in a manipulator basic body in adetachable manner.
 20. An instrument according to claim 1, characterizedby the shaft of said drive wheel being attached in said wheel carrier ina detachable manner.
 21. A medical instrument which is provided with amanipulator having a guide channel on which at least one drive wheel andat least one guide wheel are disposed, the perimeter area of which canbe brought to engage with the outer contour of an instrument part insuch a manner that said instrument part can be moved forward andbackward in the direction of its longitudinal axis relative to saidmanipulator, characterized by for adaption to the different outsidediameters of the to-be-moved instrument parts, at least one of saidwheels being provided with an elastic coating on its outer contour andone of said wheels being provided with two screws which act upon theaxis of said wheel to move it, the axis of said moveable wheel beingpretensioned by a spring in the opposite direction of the screwing indirection.
 22. An instrument according to claim 21, characterized bysaid manipulator having two wheels positioned opposite each other. 23.An instrument according to claim 21, characterized by one said drivewheel being coated with a rubber-like material in the region with whichit engages with the outer contour of said to-be-moved instrument part.24. An instrument according to claim 23 characterized by saidrubber-like material being a silicone rubber.
 25. An instrumentaccording to claim 23, characterized by the perimeters of said wheelsbeing provided with two O-rings and by said wheels being disposed insuch a manner that two O-rings are positioned opposite each otherrespectively, and by said O-rings enclosing a gap through which saidinstrument part passes.
 26. An instrument according to claim 21characterized by said moveable wheel for adaption to differentinstrument diameters being said drive wheel.